Home ›
NPI 1790075315
NPI deactivated
1790075315
1790075315 was paid $21.55M by Medicaid between Jan 2018 and Oct 2022, across 104 billing codes. Its largest line is T1015, a visit at a community health center or clinic (one all-in rate) — 81% of everything it billed.
33Billing provider info1790075315
33aNPI1790075315
33bProvider type—
28Total paid$21.55M
24GClaims196,282
24DCodes billed104
24AFirst – last monthJan 2018 – Oct 2022
Box 24A · Dates of service
Paid by month
Paid that monthNov–Dec 2024: claims still arriving when the file was cut, so these months run low for every provider
By year, as a table
| Year | Claims | Paid | |
|---|---|---|---|
| 2018 | 23,892 | $5.04M | |
| 2019 | 34,501 | $4.86M | |
| 2020 | 69,209 | $5.69M | |
| 2021 | 49,270 | $4.29M | |
| 2022 | 19,410 | $1.67M |
Box 24 · Service lines
What it billed for
| Code | Service | Share | Claims | Bene. records | Paid |
|---|---|---|---|---|---|
| T1015 | A visit at a community health center or clinic (one all-in rate)Clinic visit/encounter, all-inclusive | 81% | 83,935 | 65,188 | $17.48M |
| 00003 | Internal/system code - not a standard HCPCS code | 18% | 16,549 | 12,103 | $3.96M |
| 99213 | Doctor's office visit, returning patient (routine)Office or other outpatient visit for the evaluation and management of an established patient, low complexity | <1% | 30,992 | 24,950 | $69K |
| 99212 | Office or other outpatient visit for the evaluation and management of an established patient, straightforward | <1% | 15,324 | 11,289 | $10K |
| 0012A | <1% | 242 | 132 | $8K | |
| 0011A | <1% | 239 | 143 | $7K | |
| 0001A | <1% | 185 | 115 | $7K | |
| 0002A | <1% | 138 | 112 | $5K | |
| 99203 | Doctor's office visit, new patient (routine)Office or other outpatient visit for the evaluation and management of a new patient, low complexity | <1% | 2,149 | 2,132 | $3K |
| 0071A | <1% | 59 | 59 | $2K | |
| 0072A | <1% | 39 | 39 | $2K | |
| 0031A | <1% | 46 | 25 | $1K |
92 more codes
| 99000 | <1% | 6,633 | $801.27 | |
| 0004A | <1% | 16 | $570.25 | |
| 81025 | <1% | 255 | $484.40 | |
| 90715 | <1% | 568 | $252.66 | |
| 90471 | Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine | <1% | 4,230 | $228.94 |
| 99382 | <1% | 124 | $157.20 | |
| 92551 | <1% | 430 | $135.52 | |
| 92552 | <1% | 1,071 | $120.73 | |
| 99214 | Doctor's office visit, returning patient (more involved) | <1% | 1,455 | $91.23 |
| 99384 | <1% | 197 | $65.12 | |
| 99201 | <1% | 205 | $55.80 | |
| 99383 | <1% | 364 | $54.83 | |
| 99202 | Office or other outpatient visit for the evaluation and management of a new patient, straightforward | <1% | 147 | $33.96 |
| 85018 | <1% | 814 | $16.44 | |
| 90472 | Immunization administration, each additional vaccine (list separately) | <1% | 2,106 | $12.00 |
| 99211 | Office or other outpatient visit for the evaluation and management of an established patient, minimal severity | <1% | 194 | $12.00 |
| 90633 | <1% | 443 | $6.00 | |
| 90696 | <1% | 83 | $6.00 | |
| 81003 | <1% | 90 | $3.14 | |
| 96160 | 0% | 2,271 | $0.00 | |
| 90734 | 0% | 292 | $0.00 | |
| G0444 | Annual depression screening, 5 to 15 minutes | 0% | 127 | $0.00 |
| 90681 | 0% | 120 | $0.00 | |
| 99394 | Periodic comprehensive preventive medicine reevaluation, established patient, adolescent (12-17 years) | 0% | 538 | $0.00 |
| 90670 | 0% | 621 | $0.00 | |
| 99173 | 0% | 1,580 | $0.00 | |
| 99392 | Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) | 0% | 841 | $0.00 |
| 81002 | 0% | 51 | $0.00 | |
| 99393 | Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) | 0% | 725 | $0.00 |
| 3077F | 0% | 92 | $0.00 | |
| 3078F | 0% | 150 | $0.00 | |
| 90710 | 0% | 168 | $0.00 | |
| 90707 | 0% | 85 | $0.00 | |
| Z6400 | 0% | 206 | $0.00 | |
| 90791 | Psychiatric diagnostic evaluation | 0% | 12 | $0.00 |
| 90460 | Immunization administration through 18 years of age via any route, first or only component | 0% | 72 | $0.00 |
| 90700 | 0% | 112 | $0.00 | |
| 83655 | 0% | 247 | $0.00 | |
| 90832 | Psychotherapy session, about 30 minutes | 0% | 143 | $0.00 |
| 99391 | Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) | 0% | 583 | $0.00 |
| 90713 | 0% | 79 | $0.00 | |
| 99401 | 0% | 25 | $0.00 | |
| 92015 | Determination of refractive state | 0% | 22 | $0.00 |
| 99395 | Periodic comprehensive preventive medicine reevaluation, established patient, 18-39 years | 0% | 361 | $0.00 |
| G8431 | Screening for depression is documented as being positive and a follow-up plan is documented | 0% | 131 | $0.00 |
| 99396 | Periodic comprehensive preventive medicine reevaluation, established patient, 40-64 years | 0% | 200 | $0.00 |
| S9470 | Nutritional counseling, dietitian visit | 0% | 28 | $0.00 |
| 90461 | 0% | 17 | $0.00 | |
| 99204 | Doctor's office visit, new patient (more involved) | 0% | 25 | $0.00 |
| 90473 | 0% | 59 | $0.00 | |
| 90750 | 0% | 12 | $0.00 | |
| G8780 | Counseling for diet and physical activity performed | 0% | 40 | $0.00 |
| 82948 | 0% | 13 | $0.00 | |
| 03 | Instill, bupivac and meloxic | 0% | 19 | $0.00 |
| G8483 | Influenza immunization was not administered for reasons documented by clinician (e.g., patient allergy or other medical reasons, patient declined or other patient reasons, vaccine not available or other system reasons) | 0% | 19 | $0.00 |
| 96161 | 0% | 57 | $0.00 | |
| H0049 | Alcohol and/or drug screening | 0% | 461 | $0.00 |
| G8510 | Screening for depression is documented as negative, a follow-up plan is not required | 0% | 4,286 | $0.00 |
| 90647 | 0% | 361 | $0.00 | |
| 90686 | 0% | 1,343 | $0.00 | |
| 36415 | Collection of venous blood by venipuncture | 0% | 2,820 | $0.00 |
| 3079F | 0% | 86 | $0.00 | |
| Z1034 | 0% | 2,352 | $0.00 | |
| 90723 | 0% | 347 | $0.00 | |
| 1220F | 0% | 383 | $0.00 | |
| Z6410 | 0% | 611 | $0.00 | |
| 3351F | 0% | 124 | $0.00 | |
| 96372 | Therapeutic, prophylactic, or diagnostic injection; subcutaneous or intramuscular | 0% | 311 | $0.00 |
| 99385 | 0% | 129 | $0.00 | |
| Z1038 | 0% | 164 | $0.00 | |
| 2001F | 0% | 182 | $0.00 | |
| Z6406 | 0% | 83 | $0.00 | |
| 3080F | 0% | 29 | $0.00 | |
| 3008F | 0% | 656 | $0.00 | |
| 90620 | 0% | 36 | $0.00 | |
| 3074F | 0% | 170 | $0.00 | |
| 1031F | 0% | 306 | $0.00 | |
| Z1032 | 0% | 195 | $0.00 | |
| 90651 | 0% | 491 | $0.00 | |
| 96110 | Developmental screening, with scoring and documentation, per standardized instrument | 0% | 236 | $0.00 |
| 99381 | 0% | 34 | $0.00 | |
| G0447 | Face-to-face behavioral counseling for obesity, 15 minutes | 0% | 180 | $0.00 |
| 90716 | 0% | 203 | $0.00 | |
| 85013 | 0% | 13 | $0.00 | |
| 90744 | 0% | 55 | $0.00 | |
| 97802 | 0% | 38 | $0.00 | |
| 81000 | 0% | 47 | $0.00 | |
| 96150 | 0% | 27 | $0.00 | |
| 99172 | 0% | 13 | $0.00 | |
| 3075F | 0% | 13 | $0.00 | |
| J3490 | Unclassified drugs | 0% | 13 | $0.00 |
| 90688 | 0% | 19 | $0.00 |
Claims and beneficiary counts add up across code × month rows, so one patient seen every month counts many times. Rows with fewer than 12 claims are suppressed by HHS, so small lines can be missing.